The present disclosure relates to medical devices, systems, and methods for wound closure. In particular, devices, systems, and methods for preventing undesired adherence of wound dressings to an applied closure device are disclosed.
Many surgical incision or wound closure devices comprise first and second base panels which are adhered to the skin on the two lateral sides adjacent the incision or wound. The base panels are then laterally coupled to one another (such as with tensioning elements) to close and maintain closure of the wound or incision. Such wound closure devices are disclosed by U.S. patent application Ser. No. 13/414,176 (U.S. Pat. No. 9,179,914), Ser. Nos. 14/958,803, 14/958,818, 14/851,059, 13/286,757 (U.S. Pat. No. 8,323,313), Ser. Nos. 14/625,366, 13/665,160, 14/180,564 (U.S. Pat. No. 9,089,328), and Ser. No. 14/180,524 (U.S. Pat. No. 9,050,086) and PCT application publication nos. PCT/US2010/000430, PCT/US2015/049671, PCT/US2012/062820, PCT/US2013/067563, PCT/US2014/016587, PCT/US2015/010188, and PCT/US2015/028066, which are incorporated herein by reference. Such closure devices are commercially available as the Zip® device available from Zipline Medical of Campbell, Calif.
After closure of the surgical incision or wound, many physicians, physician assistants, nurses, and other associate caregivers and medical professionals typically apply a wound dressing to the incision or wound. The purpose of the wound dressing use may vary, but can include any or all of the following: absorption of wound exudate, minimizing infection risk, protecting the wound during bathing and other patient activities, and preventing patient visualization and/or tampering with the wound site. Wound dressings may be applied immediately after surgical closure, or at any time during the post-surgical wound healing. Wound dressings may also be removed at any time during the post-surgical wound healing period, and replaced with a new dressing as needed.
Wound dressings can come in various shapes and configurations. One common dressing configuration is the “island dressing” which comprises of an absorbent central pad surrounded on all sides by a skin adhesive. Many commercially available dressings are available. Examples of dressing types desired for use with closure devices include, but are not limited to: Convatec Aquacel™ Ag, Smith & Nephew Opsite® Post-Op, Argentum Medical Silverlon®, and Mölnlycke Mepilex® Border.
Typically the central pad does not have a skin adhesive, though some brands (e.g., Mölnlycke Mepilex® dressings) provide a low-tack adhesive such as silicone, across the pad. Other dressings may comprise of a thin polyurethane-acrylic adhesive film laminate (e.g., 3M Tegaderm®) to cover and protect the wound. Dressings can also be fashioned by the user, such as by applying gauze or Telpha pads to the wound and securing them with tape or polyurethane-adhesive films. The wound dressing pad and/or adhesive itself may or may not incorporate anti-microbial substances such as silver, chlorhexidine, and others well-known in the art. Pressure sensitive adhesives are typically used for adherence of the dressing to the skin, with the most common being derived from acrylic, hydrocolloid, or silicone. Other skin adhesives may also be used that are readily available from commercial sources.